Clinical characteristics of patients with Aspergillus species isolation from respiratory samples: Comparison of chronic pulmonary aspergillosis and colonization

• Published in: Respiratory investigation 2016-03, Vol.54 (2), p.92-97
• Main Authors: Ohara, Sayaka, Tazawa, Yoko, Tanai, Chiharu, Tanaka, Yoshiaki, Noda, Hiromichi, Horiuchi, Hajime, Usui, Kazuhiro
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aspergillus - classification; Aspergillus - growth & development; Aspergillus - isolation & purification; Aspergillus species; Asthma - complications; Body Mass Index; Chronic Disease; Chronic pulmonary aspergillosis; Cohort Studies; Colonization; Female; Humans; Internal Medicine; Male; Malnutrition - complications; Middle Aged; Prevalence; Pulmonary Aspergillosis - etiology; Pulmonary Aspergillosis - microbiology; Pulmonary Aspergillosis - mortality; Pulmonary/Respiratory; Respiratory samples; Respiratory System - microbiology; Retrospective Studies; Survival Rate; Thoracic Surgical Procedures - adverse effects; Thoracic Surgical Procedures - statistics & numerical data; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - epidemiology
• ISSN: 2212-5345; 2212-5353
• DOI: 10.1016/j.resinv.2015.08.007

Abstract Background With advancements in anti-fungal drugs, it has become more important to correctly diagnose chronic pulmonary aspergillosis (CPA); however, it is not easy to distinguish CPA from colonization when Aspergillus species are isolated from respiratory samples. The aim of the study was to clarify the particular clinical characteristics of patients with CPA vs. those with colonization. Methods We retrospectively reviewed the medical records of 110 patients with Aspergillus species isolation from respiratory samples, to analyze and compare the differences between CPA and colonization of the Aspergillus species. Results The median age of all analyzed was 71 years (range: 31–92 years); 64 were female (58%). The most frequently cultured Aspergillus species was Aspergillus fumigatus (48.3%), followed by A. niger (29.2%). Thirty patients (27.4%) were diagnosed with CPA, vs. 75 (68.2%) with colonization and 5 (4.5%) with allergic bronchopulmonary aspergillosis. Compared with the colonization group, the CPA group included more males (CPA vs. colonization: 49.3% vs. 13.3%) and subjects with a low body mass index (18.45 kg/m2 vs. 21.09 kg/m2 ). As for the underlying pulmonary diseases, the patients with CPA showed a significantly higher prevalence of sequelae of pulmonary tuberculosis (40% vs. 8%) and a history of thoracic surgery (43% vs. 13%) than those with colonization. Asthma was less frequent in the CPA group than in the colonization group (0% vs. 20%). We found no significantly important underlying extrapulmonary diseases. Conclusions Patients with CPA display clinical characteristics distinct from those seen in subjects with colonization.